Propofol and Dexmedetomidine potentially maintain BIS, MAP, and BGA in Brain Tumor Patients

Taufik Suryadi Ismail, Kulsum Kulsum, Khairuddin Khairuddin, Fachrul Jamal

Abstract


Introduction: Brain tumors have a high morbidity and mortality rate in Indonesia. According to data from the Ministry of Health, in 2020 the incidence of brain tumors was around 1.5 percent of all tumor cases. Anesthesia for brain tumor removal surgery has a high risk of postoperative complications such as hypotension, bleeding and intracranial infection. Propofol and dexmedetomidine are often used as anesthetic agents in neurosurgery that affect hemodynamics, depth of anesthesia and blood gas analysis. This study aims to determine the comparative effectiveness of propofol compared to dexmedetomidine on Bispectral Index (BIS), mean arterial pressure (MAP), and blood gas analysis (BGA) in patients undergoing intracranial tumor removal surgery.
Subject and Method: This study is an unpaired numerical comparative analytical observational study. A total of 42 participants who met the inclusion and exclusion criteria were randomly assigned into 2 groups, namely the propofol and dexmedetomidine groups. Furthermore, an assessment of mean arterial pressure, BIS, and BGA was carried out.
Results: Based on statistical tests using the unpaired T test, it was found that intraoperative MAP was significantly different between the two groups (p<0.05), where dexmedetomidine had a more stable MAP. While in BIS and BGA there was no significant difference in the two groups (p>0.05) statistically using the Mann Whitney test.
Conclusion: Dexmedetomidine has an effect that is not much different compared to propofol in maintaining changes in MAP, BIS and BGA in patients with intracranial tumor removal surgery.

 


Keywords


Bispectral, blood gas analysis index, mean arterial pressure, dexmedetomidine, intracranial tumor removal surgery, propofol

Full Text:

PDF

References


Kulsum K, Syahrul S, Hasballah K, Balqis U. Propofol and Nigella sativa L seeds ethanol extract enhance neuroprotection: A histopathological study in rat models with traumatic brain injury. Indones Biomed J. 2024; 16(5): 450–8. Doi: https://doi.org/10.18585/inabj.v16i5.3258

Gupta A, Dwivedi Y, Saxena S, Srivastava U, Mangla S, Mishra S. A randomized control study of dexmedetomidine versus fentanyl as an anesthetic adjuvant in supratentorial craniotomies. Anaesth Intensive Care. 2017; 21(3); 306–11.

Mulyadi R, Hatta M, Islam AA, Murtala B, Tammase J, Firdaus M, et al. Intratumoral and peritumoral apparent diffusion coefficient and MGMT mRNA expression meningioma histopathological grade. Indones Biomed J. 2021; 13(3): 97–105. Doi: https://doi.org/10.18585/inabj.v13i1.1338

Sidipratomo P, Prija TKS, Murtala B, Purwadianto A, Lawrence GS. Role of postmortem multislice computed tomography scan in close blunt head injury. Indones Biomed J. 2014; 6(2): 101–6. Doi: https://doi.org/10.18585/inabj.v6i2.36

Kulsum K, Suryadi T. Neuro-anesthetic management of craniotomy-surgery in removal tumor multiple meningioma patients: A case report. Open Access Maced J Med Sci. 2021;9(C):146–50. Doi:10.3889/oamjms.2021.6371

Butterworth J, Mackey D, Wasnick J. Morgan and Mikhail’s Clinical Anesthesiology. 6th ed. McGraw-Hill Education; 2018.

Coles JP, Leary TS, Monteiro JN, Brazier P, Summors A, Doyle P, et al. Propofol anesthesia for craniotomy: A double-blind comparison of remifentanil, alfentanil, and fentanyl. J Neurosurg Anesthesiol. 2000;12(1):15–20. Doi: 10.1097/00008506-200001000-00004

Abrar A, Kulsum K, Rahmi R. Effectiveness of dexmedetomidine compared with propofol on hemodynamic changes, stress response and outcome in emergency craniotomy patients. Thesis. Universitas Syiah Kuala; 2022.

Chattopadhyay U, Mallik S, Ghosh S, Bhattacharya S, Bisai S, Biswas H. Comparison between propofol and dexmedetomidine on depth of anesthesia: A prospective randomized trial. J Anaesthesiol Clin Pharmacol. 2014;30(4):550–4. Doi: 10.4103/0970-9185.142857

Roy A, Sarkar S, Chatterjee A, Banerjee A comparative study between dexmedetomidine and propofol for maintaining depth of anesthesia in elective craniotomy: a prospective randomized double blind study. Int J Res Med Sci. 2015;3(11):3238–44. Doi:10.18203/2320-6012.IJRMS20151169

Rhun EL, Weller M. Sex-specific aspects of epidemiology, molecular genetics and outcome: primary brain tumours. Gender-dependent outcomes. ESMO Open. 2020;5 (Suppl 4):e001034. Doi: 10.1136/esmoopen-2020-001034

Wang D, Song Z, Zhang C, Chen P. Bispectral index monitoring of the clinical effects of propofol closed-loop target-controlled infusion. Medicine (Baltimore). 2021 Jan 29;100(4):1-7. Doi: 10.1097/MD.0000000000023930

Gracia CZ, Hanafie A, Nasution AH. Comparison of hemodynamic response between propofol and thiopental as an induction agent in neurosurgery anesthesia at Haji Adam Malik General Hospital Medan-Indonesa. Bali Med J. 2018;7(3):717–22. Doi: https://doi.org/10.15562/bmj.v7i3.1046

Hung YC, Lee EJ, Chen HY, Ko SW, Shyr MH, Chen TY. Effects of propofol sedation during the early postoperative period in hemorrhagic stroke patients. Acta Anaesthesiol Taiwanica [Internet]. 2009;47(3):128–33. Doi:10.1016/S1875-4597(09)60039-4

Tánczos K, Németh M, Molnár Z. The Multimodal Concept of Hemodynamic Stabilization. Front Public Health. 2014;2:34:1–4. Doi: 10.3389/fpubh.2014.00034

Kumar M, Kumar A, Yadav JBS, Bhardwaj SK, Singh AK. Anesthetic stability of propofol, dexmedetomidine, and isoflurane by Measuring Bispectral Index (BIS) and hemodynamic indices: a comparative study. Cureus. 2022;14(5):1–10. Doi: 10.7759/cureus.24930

Jadhav N, Wasekar N, Wagaskar V, Kondwilkar B, Patil R. Use of dexmedetomidine in patients undergoing craniotomies. J Clin Diagnostic Res. 2017;11(1):UC01–8. Doi: 10.7860/JCDR/2017/24002.9235

Wang K, Wu M, Xu J, Wu C, Zhang B, Wang G, et al. Effects of dexmedetomidine on perioperative stress, inflammation, and immune function: systematic review and meta- analysis. Br J Anaesth 2019;123(6):777–94. Doi: 10.1016/j.bja.2019.07.027

Venn RM, Hell J, Grounds RM, George S. Respiratory effects of dexmedetomidine in the surgical patient requiring intensive care. Crit Care. 2000;4(5): 302–8. Doi: 10.1186/cc712

Kasuya Y, Govinda R, Rauch S, Mascha EJ, Sessler DI, Turan A. The correlation between bispectral index and observational sedation scale in volunteers sedated with dexmedetomidine and propofol. Anesth Pharmacol. 2009;109(6):1811–5. Doi: 10.1213/ANE.0b013e3181c04e58




DOI: https://doi.org/10.24244/jni.v15i1.711

Refbacks

  • There are currently no refbacks.


 

JNIis licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License